Medications

Topical medicines

Treatment using more than one topical medicine is often done. This can help prevent side effects from some of the stronger medicines. For example, you may use one medicine during the week but another on the weekend.

• For mild psoriasis, you may be able to control psoriasis using an over-the-counter medicine, including corticosteroid creams.
• For moderate to severe psoriasis, you may need to use a topical medicine prescribed by your doctor, such as a corticosteroid or a medicine related to vitamin D called calcipotriene. Other topical medicines include anthralin and tars.

Your doctor may have you use occlusion therapy. This means wrapping the skin after applying moisturizers or medicated creams or gels. The wrap can be fabric or plastic. Occlusion keeps the area moist and can make the medicated creams work better. Steroid cream may be used with the occlusion treatment method for small areas, but not for more than a few days. Occlusion of large areas may cause side effects such as thinning of the skin. Talk to your doctor before using occlusion therapy, to make sure that you do it safely.

Pills or shots

Medicines taken by mouth (oral medicines) may be used to treat moderate to severe psoriasis.

Sometimes this type of medicine is given as shots instead of pills.

Biologics

Medicines called biologics may be used to treat severe psoriasis or psoriasis that hasn't improved after other treatments. Biologics are similar to or the same as proteins made by the body. These medicines block the harmful response of the body's immune system that causes the symptoms of psoriasis.

These medicines are given through a needle (IV). Early clinical trials of biologic therapies for moderate to severe psoriasis have produced promising results. But the medicines are expensive, and long-term effects aren't known. Biologics may increase the long-term risk of cancer or infections.⁴

Medication Choices

Over-the-counter topical medicines. There are many types of nonprescription products, including corticosteroid creams, for psoriasis. Examples of their active ingredients include:

• Salicylic acid, found in products such as Psoriasin Body Wash or Dermasolve e70.
• Coal tar, found in products such as Elta Tar or Neutrogena T/Gel.
• Zinc pyrithione, found in products such as SkinCure and Derma-Cap. These are new products that come in spray, soap, or solution form.

These products are used to treat small patches of psoriasis and symptoms, including itching, redness, flaking, and scaling of the skin and scalp. For some people, they may eliminate scales and sores caused by psoriasis.

Topical medicines that a doctor prescribes:

• Corticosteroids, which are the most common treatment for psoriasis. Betamethasone is an example of a topical corticosteroid.
• Calcipotriene, which is a form of vitamin D.
• Retinoids, which are medicines related to vitamin A. An example is tazarotene.
• Anthralin and tars. The use of anthralin and tars has decreased recently, replaced by other medicines such as calcipotriene and tazarotene.

Topical medicines used with ultraviolet (UV) light (phototherapy):

• Psoralen and UVA light (called PUVA).
• Tars and UVB light (called Goeckerman treatment).
• Anthralin and UVB light (called the Ingram regimen).

Pills:

• Retinoids.
• Cyclosporine.
• Methotrexate.

Biologics:

Biologics used to treat psoriasis or psoriatic arthritis include adalimumab (Humira) and other medicines, such as etanercept (Enbrel), infliximab (Remicade), or ustekinumab (Stelara).

What To Think About

Some medicines used to treat psoriasis can cause serious side effects. You and your doctor will discuss how long to use treatments that could cause harm. You will also need to see your doctor regularly and may have blood tests while using some medicines.

Many oral or injected medicines used to treat psoriasis aren't safe during pregnancy. If you are pregnant, talk to your doctor before taking any medicines.